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Clinical Advances in the Diagnosis and Treatment of Cardiac Arrhythmias

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: 15 January 2026 | Viewed by 1770

Special Issue Editors


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Guest Editor
Electrophysiology Unit, Cardio-Thoraco-Vascular Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Interests: atrial fibrillation ablation; ventricular tachycardia ablation; supraventricular tachycardia ablation; left atrial appendage closure; ICD/PM implantation; cardiac leads extraction
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, 20126 Milan, Italy
Interests: arrhythmic risk stratification; sudden death; genetics; arrhythmogenic dysplasia; hypertrophic heart disease; inflammatory cardiomyopathy; dilated cardiomyopathy; ischaemic cardiomyopathy; channelopathies; cardiac magnetic resonance; late gadolinium enhancement; multiparametric evaluation; ventricular arrhythmias; heart failure; electrophysiological study; ventricular arrhythmia ablation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiac arrhythmias encompass a broad and heterogeneous spectrum of clinical conditions, often requiring sophisticated diagnostic and therapeutic approaches. In recent years, substantial progress has been achieved in diagnostic accuracy, risk stratification, and the personalization of treatment strategies. Contemporary management integrates advanced imaging modalities, genetic profiling, and electroanatomic mapping to support patient-specific therapeutic decisions. Pharmacological treatment remains a central pillar, evolving from traditional antiarrhythmic agents to novel compounds targeting distinct atrial and ventricular substrates, with the goal of maximizing efficacy while minimizing proarrhythmic risk. In parallel, device-based therapies have undergone continuous refinement—ranging from transvenous devices to leadless pacemakers, a wide array of implantable cardioverter-defibrillators, including subcutaneous and extravascular systems, as well as cardiac resynchronization technologies. Catheter ablation has become a cornerstone in the treatment of both atrial and ventricular arrhythmias, with the growing adoption of tailored ablation protocols. Remote monitoring and AI-supported diagnostics exemplify the transition toward precision medicine. Moreover, interdisciplinary collaboration among electrophysiologists, imaging experts, and cardiac surgeons fosters safer, more effective, and durable interventions. This Special Issue aims to present recent developments in the diagnostic, pharmacological, and interventional management of cardiac arrhythmias, emphasizing how scientific progress can continue to refine and expand clinical practice in arrhythmology.

Dr. Fabrizio Guarracini
Dr. Marisa Varrenti
Guest Editors

Manuscript Submission Information

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Keywords

  • cardiac arrhythmias
  • antiarrhythmic agents
  • pacemakers
  • cardiac resynchronization
  • catheter ablation
  • electrophysiology

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Published Papers (2 papers)

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Research

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15 pages, 4624 KB  
Article
AI-Assisted 3D Intracardiac Echocardiography for Pulsed Field Ablation of Atrial Fibrillation Using a Novel Variable Loop Circular Catheter: A Multicenter Evaluation
by Antonio Dello Russo, Yari Valeri, Giuseppe Ciconte, Marco Schiavone, Paolo Compagnucci, Antonio Di Monaco, Stefania Riva, Raffaele Salerno, Giovanni Volpato, Laura Cipolletta, Quintino Parisi, Michela Casella, Massimo Grimaldi, Claudio Tondo and Carlo Pappone
J. Clin. Med. 2025, 14(20), 7249; https://doi.org/10.3390/jcm14207249 - 14 Oct 2025
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Abstract
Background: The VARIPULSE platform is an advanced Pulsed Field Ablation (PFA) system fully integrated with electro-anatomical mapping system, employing a variable loop circular catheter (VLCC) for atrial fibrillation (AF) ablation. The objective of the study is to assess for the first time the [...] Read more.
Background: The VARIPULSE platform is an advanced Pulsed Field Ablation (PFA) system fully integrated with electro-anatomical mapping system, employing a variable loop circular catheter (VLCC) for atrial fibrillation (AF) ablation. The objective of the study is to assess for the first time the feasibility, safety, and procedural impact of AI (artificial intelligence)-assisted ICE (intracardiac echocardiography) mapping with the CARTOSOUND FAM Module compared with conventional electroanatomical mapping during PFA. Methods: In this retrospective, multicenter study, 157 consecutive patients undergoing PFA for paroxysmal or persistent AF were included. Patients were divided into two groups: ICE-guided cohort (n = 64) and non-ICE-guided cohort (n = 93). Propensity score matching (PSM) was used to adjust for baseline differences. Results: AI-assisted ICE mapping was feasible in all cases. Compared with conventional mapping, it significantly reduced LA (left atrium) mapping time (median 5 vs. 8 min; p < 0.001), LA dwell time (33.5 vs. 38.5 min; p = 0.001), and fluoroscopy time (7.5 vs. 14 min; p < 0.001). The total number of PFA applications was similar across groups (p = 0.136). No major adverse events occurred in either cohort during the procedure or within the first month of follow-up. Conclusions: AI-assisted ICE mapping using the CARTOSOUND FAM Module enables accurate anatomical reconstruction and significantly optimizes procedural efficiency in PFA. This approach supports further development toward radiation-sparing and potentially fluoroscopy-free PFA workflows. For the first time, it addresses a gap in the current evidence regarding the use of ICE in PFA, building on evidence already established for radiofrequency ablation procedures. Full article
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Review

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13 pages, 584 KB  
Review
Idiopathic Ventricular Arrhythmias Originating from the Left Ventricular Summit: A Diagnostic and Therapeutic Challenge
by Raffaele Falco, Chiara Tognola, Lorenzo Gigli, Matteo Baroni, Antonio Frontera, Marisa Varrenti, Alberto Preda, Marco Carbonaro, Roberto Menè, Leandro Fabrizio Milillo, Andrea Sultana, Sara Vargiu, Giulia Colombo, Federica Giordano, Cristina Giannattasio, Patrizio Mazzone and Fabrizio Guarracini
J. Clin. Med. 2025, 14(12), 4261; https://doi.org/10.3390/jcm14124261 - 16 Jun 2025
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Abstract
Premature ventricular contractions (PVCs) originating from the left ventricular summit (LVS) present a diagnostic and therapeutic challenge due to their complex anatomical location. The LVS includes an epicardial area of the left ventricle bordered by major coronary arteries, which has been increasingly recognized [...] Read more.
Premature ventricular contractions (PVCs) originating from the left ventricular summit (LVS) present a diagnostic and therapeutic challenge due to their complex anatomical location. The LVS includes an epicardial area of the left ventricle bordered by major coronary arteries, which has been increasingly recognized as an arrhythmic focus. Idiopathic ventricular arrhythmias from this area may exhibit specific electrocardiographic characteristics, making accurate localization essential for effective management. Methods: This narrative review explores the primary features of this arrhythmia, emphasizing key diagnostic and therapeutic aspects, including both pharmacological and interventional approaches, considering the recent technological advances in cardiac mapping and ablations. Conclusions: PVCs originating from the left ventricular summit (LVS) exhibit characteristic electrocardiographic features. Prompt recognition of this arrhythmia may facilitate appropriate referral for targeted treatment. Full article
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